Sean McNamara and Christian Troy are best friends and own a plastic surgery practice together. Their friendship and business is put to the test when Christian, unbeknownest to Sean, accepts drug money to perform surgery on a Columbian drug lord. At home, Sean's relationship with his wife, Julia, begins to strain.

At Sean's insistence, Christian agrees to hire a staff psychologist. However, the male candidate they choose is no more ethical than Christian. As Sean and Julia continue having trouble in their marriage, Sean becomes attracted to psychologist Dr Grace Santiago.

Christian becomes furious when Sean agrees with Grace, now the practice's in-house psychologist, about a woman's desire for extensive surgery in order to look beautiful for her high school reunion. Julia is ordered to attend anger management classes when she is reported to animal services for flushing Annie's pet gerbil down the toilet.

Christian tries to persuade Sean to go into business with a successful pornography production company whose performers need cosmetic surgery. However, the new arrangement causes problems when the practice's more upscale clients feel uneasy. Sean examines a young transsexual, Sofia Lopez, who wants to correct a botched sex-change procedure.

Sean and Christian interview a potential patient, a Caucasian man who wants his eyes to look Asian. Meanwhile, Julia must choose between medical school and motherhood again when she discovers that shea 's pregnant.

When Christian's prized possessions are vandalized, he contacts the women he has wronged in the past to find the culprit. In the process, he reconsiders his behavior towards women in general. Meanwhile, Sean is invigorated after an encounter with a patient, Megan O'Hara, a chiropractor going through a divorce.

Julia clashes with Sean regarding how to parent Matt, but Matt appreciates his father's support. Meanwhile, Christian attempts to maintain an honest relationship with his girlfriend and Sean visits Megan O'Hara for more than just a chiropractic session.

While driving his friend Henry home, Matt hits pedestrian Cara Fitzgerald. Guilt-stricken, Matt visits the comatose girl in hospital and meets her mother, a strict Christian Scientist who refuses to allow doctors to do any re-constructive surgery on Cara's terribly injured face.

Christian accompanies his girlfriend Kimber to a spa where they encounter rival plastic surgeon Merrill Bobolit. Nurse Liz becomes closely involved with male-to-female sex-change patient Sofia Lopez, while Sean and Megan finally consummate their relationship in a hotel.

An error during surgery causes Christian to lose his confidence before a medical board test, and Sean is devastated by Megan's illness. When she asks him to help her commit suicide so she can die with dignity, he agrees.

After operating on Montana Caine, Sean and Grace are astounded to discover that she has a multiple personality disorder. Meanwhile, two gay men beg Christian to help get medical cover for their adopted son since they can't legally receive benefits.

Christian and Sean operate on a South American woman and discover that shea 's being used to carry liquid heroin into the US in her breast implants. Ruthless Colombian drug lord Escobar Gallardo blackmails them into removing the implants and handing them over.

In the season finale, Escobar Gallardo's demands that Sean and Christian perform free breast implant removal operations on the women he uses to smuggle heroin nearly force the practice into financial ruin. When they refuse, Escobar resorts to violence. Meanwhile, Sean's troubles at home worsen and he and Julia move closer to divorce.